Magnetic Resonance Lymphangiography
Magnetic Resonance Lymphangiography (MRL) is an imaging technique used to visualize and map lymphatic channels and their course. The technique is used for treatment planning in supermicrosurgical procedures including lymphaticovenous anastomosis, lymphaticolymphatic bypass and vascularized lymph node transfers.
The technique requires a 1.5T or greater MRI and access to a multi-element coil. Both phased-array peripheral vascular coils and body array coils are reported to provide good signal-to-noise ratio1. A 0.1 mmol/kg body weight dose mixture of gadobenate dimeglumine and 1% lignocaine HCL is injected intradermally or subcutaneously in the region of interest. The patient is subsequently imaged using a 3D fast spoiled gradient-echo T1-weighted sequence with a fat-saturation technique to faclilitate visualization of lymphatic channels. Subtraction of a pre-contrast study from a post-contrast study has also been reported1 in literature as a method to increase the apparent contrast in the examination.
- 1. Mazzei, Francesco Giuseppe, Gentili, Francesco, Guerrini, Susanna, Cioffi Squitieri, Nevada, Guerrieri, Duccio, Gennaro, Paolo, Scialpi, Michele, Volterrani, Luca, Mazzei, Maria Antonietta. MR Lymphangiography: A Practical Guide to Perform It and a Brief Review of the Literature from a Technical Point of View. (2018) BioMed Research International. 2017: 2598358. doi:10.1155/2017/2598358 - Pubmed